Active NPI
Jessica Ivellise Correa, RPHTECH
- Pharmacy Technician
- Rio Grande, PR
National Provider Identifier
1376649681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 4573
- Practice address
- Carr 3 KM 28.8
Rio Grande, PR 00745 - Phone
- (787) 887-2602
- Fax
- (787) 809-8398
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 4573 | PR | Primary |
Addresses
Primary practice location
Carr 3 KM 28.8
Rio Grande, PR 00745
Mailing address
28 Calle Soledad
Rio Grande, PR 00745-2934
Phone (787) 887-2602
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4573 | Other | PR | PHARMACY TECH. LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4573 | PR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376649681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 CALLE SOLEDAD",
"city": "RIO GRANDE",
"state": "PR",
"postal_code": "007452934",
"telephone_number": "787-887-2602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 3 KM 28.8",
"city": "RIO GRANDE",
"state": "PR",
"postal_code": "00745",
"telephone_number": "787-887-2602",
"fax_number": "787-809-8398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORREA",
"first_name": "JESSICA",
"middle_name": "IVELLISE",
"name_prefix": "Mrs.",
"credential": "RPHTECH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "PR",
"license": "4573",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY TECH. LICENSE",
"identifier": "4573",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rio Grande, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.